NPIMap

Organization Active NPI

Kevin Park, DDS, Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1760058929
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KEVIN PARK, DDS, INC.
Practice address
104 W 7TH St
Los Angeles, CA 90014-1906
Phone
(626) 215-5810
NPI assigned
May 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin Park, DDSNPI 1295102317
Title
Owner
Phone
(626) 215-5810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

104 W 7TH St
Los Angeles, CA 90014-1906

Mailing address

104 W 7TH St
Los Angeles, CA 90014-1906

National Provider Directory

National Provider Directory

Locations

104 W 7th St
Los Angeles, CA 90014
Phone (626) 215-5810

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1760058929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 7TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 7TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141906",
            "telephone_number": "626-215-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN PARK, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-215-5810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.